Insurance Claim Demand Letter Example

Dear Claims Department,

We are writing to formally dispute the denial of our homeowner's insurance claim (Claim No. HO-2025-88743) and to demand payment of $12,300.00 for covered losses sustained during Hurricane Milton on September 26, 2025. Your denial letter dated November 15, 2025 is factually inaccurate and inconsistent with the terms of our policy.

Policy Coverage:

Our homeowner's policy (HO-FL-9927841, effective July 1, 2025 through June 30, 2026) provides coverage for "direct physical loss to property" caused by windstorm, including wind-driven rain. The policy has a $1,000 hurricane deductible. We have maintained continuous coverage with Sunshine State Insurance for 11 years and have never filed a prior claim.

The Loss:

On September 26, 2025, Hurricane Milton made landfall near Sarasota, FL. Our property in Palm Bay experienced sustained winds of 85-95 mph and gusts exceeding 110 mph, as documented by the National Weather Service Melbourne station. The storm caused the following damage to our property:

1. Roof damage: Multiple shingles torn away from the northwest corner, exposing underlayment. Three areas of flashing separated from the roof deck. Total estimate: $6,800
2. Window damage: Two impact-resistant windows cracked by wind-borne debris (east-facing master bedroom and guest room). Total estimate: $2,200
3. Interior water damage: Wind-driven rain entered through the compromised roof, causing water damage to the master bedroom ceiling, wall, and carpet. Total estimate: $4,300
Total claim: $13,300 − $1,000 hurricane deductible = $12,300.00

Your Denial and Why It's Wrong:

Your denial letter states that the damage was caused by "pre-existing wear and deterioration" rather than the hurricane. This conclusion was apparently based on a 15-minute inspection by your field adjuster, Mr. Thomas Reed, on October 20, 2025 — 24 days after the storm.

Mr. Reed's assessment is contradicted by:

1. Our home inspection report from July 2024 (conducted for refinancing), which rated the roof in "good condition" with an estimated remaining useful life of 12-15 years. The roof was installed in 2018 — only 7 years old at the time of loss.

2. An independent assessment by Carlos Medina, Licensed Public Adjuster (FL License #W291847), who inspected the property on November 28, 2025. Mr. Medina's detailed 14-page report, with photographic documentation, concludes that all damage is "consistent with wind damage from a Category 1+ hurricane" and identifies no pre-existing deterioration.

3. National Weather Service records confirming sustained hurricane-force winds at our location on the date of loss.

4. Our neighbors' identical claims — at least four homes on our street sustained similar roof damage from the same storm, and their claims with other insurers were paid.

Legal Basis:

Your denial constitutes unfair claim settlement practices under Florida law:

1. Florida Statute § 626.9541(1)(i)(3)(a): Failing to adopt and implement reasonable standards for the prompt investigation and settlement of claims.

2. Florida Statute § 626.9541(1)(i)(3)(c): Failing to provide a reasonable explanation for the denial of a claim based on all available information.

3. Florida Statute § 626.9541(1)(i)(3)(f): Not attempting in good faith to settle claims when liability has become reasonably clear.

Under Florida Statute § 624.155, any party may bring a civil action against an insurer for not attempting in good faith to settle claims. A finding of bad faith entitles the insured to recover damages, attorney's fees, and costs. Additionally, the Florida Department of Financial Services may impose administrative penalties.

Demand:

We demand payment of $12,300.00 within thirty (30) days of your receipt of this letter. This represents the documented claim amount less our hurricane deductible.

If Payment Is Not Received:

1. We will file a Civil Remedy Notice under Florida Statute § 624.155, triggering the 60-day cure period for bad faith claims;
2. We will file a complaint with the Florida Division of Consumer Services (1-800-435-7352);
3. We will retain counsel to pursue a bad faith insurance action, in which your company will be liable for the claim amount, attorney's fees, costs, and any consequential damages;
4. We will request that the Florida Office of Insurance Regulation review your company's claim denial patterns for this storm.

We have been loyal policyholders for over a decade. We expect Sunshine State Insurance to honor its contractual obligations.

Sincerely,